Development of a short form of the Brazilian Parental-Caregiver Perceptions Questionnaire using exploratory and confirmatory factor analysis

Perceptions of Parents/Caregivers About the Impact of Oral Conditions on the Quality of Life of Children and Adolescents with Autism Spectrum Disorder

PURPOSE

To investigate the perceptions of parents/caregivers about the impact of oral conditions on the oral health-related quality of life (OHRQoL) of children/adolescents with autism spectrum disorder (ASD) compared to the perceptions of parents/caregivers of children/adolescents without ASD.

METHODS

A comparative cross-sectional study was conducted involving 80 children/adolescents with ASD three to 16 years of age matched by sex and age with 80 children/adolescents without ASD and their parents/caregivers. Clinical examinations were performed for the diagnosis of dental caries experience (DMFT/dmft), clinical consequences of untreated dental caries (PUFA/pufa), visible plaque (VPI), bleeding on probing (BPI), malocclusion and traumatic dental injury (TDI). Parents/caregivers answered a questionnaire addressing sociodemographic characteristics and the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ), which measures OHRQoL from the perspective of parents/caregivers. Data analysis involved the Wilcoxon test, chi-squared test and Poisson regression.

RESULTS

Dental caries experience impacted OHRQoL in the group with ASD regarding the total P-CPQ score (p < 0.001) as well as the "oral symptoms" (p = 0.011) and "wellbeing" (p < 0.011) domains. No differences were found between the perceptions of parents/caregivers of children/adolescents with ASD and perceptions of parents/caregivers of children/adolescents without ASD (p = 0.721).

CONCLUSION

Dental caries experience can have a negative impact on the OHRQoL of children/adolescents with ASD.

Pharmacist's knowledge and attitude towards self-medication practices: a cross-sectional study for the development and validation of questionnaire

BACKGROUND

Pharmacists play an essential role in self-medication by providing guidance and counselling services to consumers; hence, it is necessary to assess pharmacists' awareness and attitude towards self-medication to promote responsible self-medication practices.

OBJECTIVE

To develop a valid and reliable instrument to assess the knowledge and attitude of pharmacists towards self-medication practices and their role in promoting responsible self-medication.

METHOD

A questionnaire was developed in English after a relevant literature review, which was further administered to a sample of 105 community pharmacists. The reliability of the questionnaire was assessed using the Karl-Pearson correlation and Cronbach alpha statistics. Content validity was evaluated by subject experts. The dimensional structure of items was assessed through exploratory factor analysis and confirmatory factor analysis (CFA).

KEY FINDINGS

The final questionnaire comprises 27 items for knowledge and attitude with a Karl-Pearson correlation value of 0.896 and Cronbach alpha value of 0.814 (24 items), indicating good internal consistency and reproducibility. Factor analysis identified five factors: namely, (i) attitude towards providing guidance and advice to consumers to promote responsible SMP, (ii) attitude towards shared responsibility for promoting rational medicine supply and use, (iii) knowledge of the advantages and disadvantages of SMP, (iv) knowledge of the definition of self-medication, (v) attitude towards professional competency of a pharmacist as a healthcare provider. CFA results demonstrate good model fit with the value of Chi-square (184.56), CFI (0.937), RMSEA (0.054), and SRMR (0.075). Model validity measures ensure satisfactory validity and reliability.

CONCLUSIONS

The findings demonstrate a valid and reliable measure for assessing the knowledge and attitude of pharmacists towards self-medication.

Agreement between schoolchildren and their parents on rating the child's oral health-related quality of life

The perceptions of parents/caregivers regarding their children's oral health can influence the standard of care and decision-making regarding oral health. The children's perspective on their own oral health-related quality of life (OHRQoL) may differ from the parents/caregivers' views. This cross-sectional study aimed to analyze the agreement between the perceptions of parents/caregivers and schoolchildren regarding OHRQoL. It was conducted with a sample of children between 8 and 11 years old and their parents/caregivers from Pelotas. Children answered the Child Perceptions Questionnaire 8-10 (CPQ), and parents/caregivers answered the short form of the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Socioeconomic data were also collected. Children's dental caries, traumatic dental injuries, and malocclusions were examined. The Spearman's correlation test was performed. A total of 119 parents/caregivers-children pairs were included. There was an agreement between the total scores of parents/caregivers and children (0.2770; p = 0.003), in the oral symptoms (0.1907; p = 0.038), and functional limitations (0.2233; p=0.015) domains. The Bland-Altman graph showed an agreement between children's and parents/caregivers' OHRQoL total score, but there was an underestimation of approximately two points in the parents/caregivers' perception compared to the children's score. There was an agreement between the reports of parents/caregivers and children regarding children's OHRQoL.

Parental Perception of the Oral Health-Related Quality of Life of Children and Adolescents with Autism Spectrum Disorder (ASD)

This study evaluated the parental perception of the oral health-related quality of life (OHRQoL) of children and adolescents with autism spectrum disorder (ASD) and their family functioning. Moreover, sociodemographic factors associated with parental ratings of OHRQoL were assessed. A hundred parents/guardians of children and adolescents aged 6 to 14 years with ASD (ASD group) and 101 unaffected children and adolescents (UCA group) participated. Data collection was carried out using a Google form, containing three sections: (1st) Socioeconomic data and health history; (2nd) Oral health assessment by parental report; (3rd) The short forms of the Parental-Caregiver Perceptions Questionnaire (16-P-CPQ) and the Family Impact Scale (4-FIS). The scores of 16-P-CPQ total and subscales and 4-FIS were significantly higher for the ASD group (p < 0.02), except for the oral symptoms subscale (p > 0.05). Older ages (OR = 1.24), brushing 0/1x day (OR = 2.21), teeth grinding (OR = 2.20), gingival bleeding (OR = 3.34), parents with an elementary school degree (OR = 0.314) and family incomes less or equal to the minimum wage (OR = 3.049) were associated with a worse OHRQoL. Parents in the ASD group had a worse perception of QHRQoL when compared to the UCA group. ‘Frequency of tooth brushing’, ‘gingival bleeding’, and ‘teeth grinding’ were predictors of the worst parental perception of their children’s OHRQoL. Families with low socioeconomic conditions were more strongly affected by the oral conditions of their children.

Getting the FACS: A Protocol for Developing a Survey Instrument to Measure Carer and Family Engagement with Mental Health Services

Government policies recommend, and all stakeholders benefit, when mental health services meaningfully engage with carers and family. However, health service engagement with carers is inadequate, and often non-existent with children whose parents are service users. There are seven fundamental ways that carers and families want to be integrated with and engaged by health services but current survey instruments do not capture these seven engagement practices. This protocol describes the development of two closely aligned Family and Carer Surveys (FACS) to measure engagement of service users in mental health services. The new measures are based on the seven engagement themes and a conceptual distinction between the carer and family, with particular focus on where the service user is a parent. The instruments will be developed in five stages; (1) item generation (2) Cognitive pretesting of survey (3) preliminary item content quantitative assessment (4) psychometric analysis of a large data collection and (5) selection of items for short form instruments. These steps will operationalise the seven fundamental ways that families and carers want to be engaged with mental health services, thereby providing valid and reliable measures for use in research and benchmarking of carer and family engagement.

Development and validation of a short form of the BOHLAT-P

The authors developed and validated a short form of the Brazilian Oral Health Literacy Assessment Task for Paediatric Dentistry (BOHLAT-P). Data included responses from 200 parents of preschoolers to sociodemographic and oral health service access questions on the BOHLAT-P, the Brazilian Rapid Estimate of Adult Literacy in Dentistry (BREALD-30), and the Brazilian Early Childhood Oral Health Impact Scale (B-ECOHIS). Data on the preschoolers' dental caries experience (ICDAS-II) were also included. An item response theory-based approach was employed to develop the short form, while confirmatory factor analysis evaluated the instrument dimensionality. The validity and reliability of the short form were tested by statistical analysis using BREALD-30, B-ECOHIS, and sociodemographic and dental caries experience data. The short form (BOHLAT-P-30) comprises 30 items, is unidimensional, and presents better model fit estimates (TLI = 0.94; CFI = 0.94; RMSEA = 0.05) than those of the BOHLAT-P. Moreover, BOHLAT-P-30 demonstrated excellent reliability (Cronbach's alpha = 0.91; intraclass correlation coefficient [ICC] = 0.95). BOHLAT-P-30 scores were positively correlated with BREALD-30 scores (r = 0.71), with the number of years of schooling (r = 0.60), and with the number of hours spent reading (r = 0.33). BOHLAT-P-30 scores were negatively correlated with B-ECOHIS scores (r = -0.21), and with the number of teeth with cavitated caries (r = -0.18). After controlling for confounding factors, BOHLAT-P-30 scores were not found to be associated with caries presence, or with the number of teeth with cavitated caries. The BOHLAT-P-30 had properties similar to those of the BOHLAT-P, and proved to be a valid measure to assess the OHL of Brazilian parents.

A New Tool for Rapid Assessment of Acute Exercise-Induced Fatigue

Background

There are limited sensitive evaluation methods to distinguish people's symptoms of peripheral fatigue and central fatigue simultaneously. The purpose of this study is to identify and evaluate them after acute exercise with a simple and practical scale.

Methods

The initial scale was built through a literature review, experts and athlete population survey, and a small sample pre-survey. Randomly selected 1,506 students were evaluated with the initial scale after exercise. Subjective fatigue self-assessments (SFSA) were completed at the same time.

Results

The Acute Exercise-Induced Fatigue Scale (AEIFS) was determined after performing a factor analysis. In the exploratory factor analysis, the cumulative variance contribution rate was 65.464%. The factor loadings of the total 8 questions were 0.661-0.816. In the confirmatory factor analysis, χ2/df = 2.529, GFI = 0.985, AGFI = 0.967, NFI = 0.982, IFI = 0.989, CFI = 0.989, and RMSEA = 0.048. The Cronbach's alpha coefficient for the scale was 0.872, and it was 0.833 for peripheral fatigue and 0.818 for central fatigue. The intra-class correlation coefficient for the scale was 0.536, and the intra-class correlation coefficients for peripheral fatigue and central fatigue were 0.421 and 0.548, respectively. The correlation coefficient between the total score of the AEIFS and the SFSA score was 0.592 (p < 0.01).

Conclusion

Our results demonstrate that the AEIFS can distinguish peripheral fatigue and central fatigue and can also reflect their correlation. This scale can be a useful evaluation tool not only for measuring fatigue after acute exercise but also for guiding reasonable exercise, choosing objective testing indicators, and preventing sports injuries resulting from acute exercise-induced fatigue.

Oral health-related quality of life in children and adolescents with cerebral palsy: paired cross-sectional study

OBJECTIVES

To evaluate the impact of oral health conditions on the Oral Health-Related Quality of Life (OHRQoL) in children and adolescents with Cerebral Palsy (CP) and compare with children and adolescents without CP.

METHODS

This was a paired cross-sectional study, consisting of 121 children and adolescents with CP and 121 without CP, aged 6 to 14 years. Caregivers filled a socioeconomic-demographic and the Parental-Caregiver Perceptions Questionnaire (P-CPQ). Physical examination of the oral cavity assessed the dental caries experience, need for treatment, consequences of untreated dental caries, presence of dental trauma, bruxism and malocclusion. A descriptive analysis and Kruskal-Wallis and Mann-Whitney tests (p < 0.05) were performed. Variables with p values ≤ 0.20 in the bivariate analysis were included in the adjusted model analysis. Variables with a p value < 0.05 remained in the final Poisson Regression model.

RESULTS

Caries experience had a negative impact on the quality of life of both groups, with and without CP. Presence of gastroesophageal reflux and difficulty to opening the mouth also had a negative impact on the OHRQoL of the group with CP.

CONCLUSION

Children and adolescents with CP suffered a greater negative impact on OHRQoL than individuals without CP. Difficulty in opening the mouth and the presence of GER had a negative effect on the quality of life of individuals with CP, while dental caries had a negative impact on the OHRQoL of children and adolescents of both groups.

Impact of dental treatment on the oral health-related quality of life of children and adolescents with Autism Spectrum Disorder

AIM

To evaluate the impact of dental treatment on the oral health-related quality of life (OHRQoL) of children and adolescents with Autism Spectrum Disorder (ASD), through the perception of caregivers.

METHODS AND RESULTS

A prospective longitudinal study was conducted on 115 individuals with ASD, 6-14 years of age, recruited from the referral centers for special needs individuals at Teresina, Brazil. A clinical examination was carried out and the OHRQoL was measured using the Brazilian version of the Parental-Caregiver Perceptions Questionnaire (P-CPQ) before and 3 months after dental treatment. Data were analyzed using Kolmogorov-Smirnov, Levene, Mann-Whitney, Kruskall-Wallis, and Wilcoxon tests, and the Poison regression with backward method (P < .05). Treatment needs of children with ASD consisted of dental restorations (81.7%), oral prophylaxis (66.1%), endodontic treatment (10.4%), and tooth extractions (10.4%). The baseline P-CPQ total score varied from 1 to 33 (mean score = 13.2 [±6.4]), and at 3 months after treatment it ranged from 0 to 10 (mean score 3.4 [±2.2] (P < .001). The effect magnitude varied between 0.55 and 0.56.

CONCLUSION

According to the perception of the caregivers, dental treatment had a positive impact on the OHRQoL of children and adolescents with ASD.

Incisor Molar Hypomineralization and Quality of Life: A Population-Based Study with Brazilian Schoolchildren

Aim

To assess the impact of incisor molar hypomineralization (MIH) on oral health-related quality of life (OHRQoL) according to the perception of students and their parents/caregivers.

Materials and Methods

This is a cross-sectional population-based study with 463 Brazilian students aged 11-14 years. OHRQoL was measured using the Child Perceptions Questionnaire (B-CPQ_11-14ISF: 16) applied to students and the short version of the Parental-Caregiver Perceptions Questionnaire (B-P-CPQ) applied to parents/caregivers. The diagnosis of MIH followed the European Academy of Paediatric Dentistry criteria modified in 2019. Caries experience (ICDAS II), malocclusion (DAI), and socioeconomic and demographic factors were assessed as confounding factors for impact on OHRQoL. Cluster analysis was carried out to dichotomize the negative impact into greater and lesser impact. The chi-square test and Poisson regression were performed (p < 0.05) to verify associations between quality of life and MIH, adjusted for confounding variables.

Results

The prevalence of MIH was 10.8%. Multivariate regression demonstrated that caries experience was the only oral disease that impacted OHRQoL according to students' self-perception in the functional limitation domain (PR = 1.82; 95% CI = 1.20-2.77) and in the total questionnaire score (PR = 1.59; 95% CI = 1.00-2.51). However, according to the perception of parents/caregivers, in addition to caries experience, which affected OHRQoL in the oral symptoms (PR = 3.57; 95% CI = 1.71-7.414) and emotional well-being domains (PR = 1.71; 95% CI = 1.08-2.69), as well as in the total B-P-CPQ score (PR = 1.67; 95% CI = 1.01-2.76), malocclusion also affected OHRQoL in the social well-being domain (PR = 1.50; 95% CI = 1.07-2.10) and in the total questionnaire score (PR = 1.54; 95% CI = 1.11-2.15).

Conclusion

According to students and their parents/caregivers' perception, incisor molar hypomineralization did not influence OHRQoL of the studied sample.

Dimensional Structure of the Early Childhood Oral Health Impact Scale

Background:

Detecting the latent dimensions of quality of life as affected by oral diseases is essential for promoting oral health in children. This study aimed to test the Early Childhood Oral Health Impact Scale (ECOHIS) via an appropriate method to detect its dimensions of quality of life as affected by oral diseases.

Methods:

An analytical cross-sectional study was carried out in Shiraz, Iran, between 2014 and 2015. A multistage stratified design was used to select 830 parents or the guardians of primary school children aged six years. The Farsi version of the Early Childhood Oral Health Impact Scale (F-ECOHIS) was used to evaluate the children’s oral health-related quality of life. The parents were interviewed to collect data on ECOHIS. Mplus, version 7, was employed for descriptive and analytical analyses in the present study. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed to extract and verify the latent dimensions of ECOHIS.

Results:

Out of the 830 invited parents or guardians, 801 participated in this study. The mean ECOHIS score was 21.95±7.45. The mean child impact score and the mean family impact score were 14.25±5.72 and 7.70±3.62, respectively. EFA yielded a 3-factor model: symptom and function, social interaction, and family impact. CFA confirmed the 3-dimensional model (root mean square error of approximation=0.045). The fit indices of the 1- and 2-dimensional models (the child and family domains) were not within the acceptable range.

Conclusion:

F-ECOHIS is a 3-dimensional model rather than the hypothetical 6-dimensional model. ECOHIS appears to be a useful scale for measuring the multidimensional impact of oral diseases in children.

Oral Health-Related Quality Of Life of Pre-School Children: Review and Perspectives for New Instruments

This study aimed to describe different approaches for the evaluation of the Oral health-related quality of life (OHRQoL) of preschool children and to discuss perspectives for future instruments. The OHRQoL is a concept that surpasses an exclusively clinical perception and includes functional, social, emotional, and environmental issues. The measure of OHRQoL represents a holistic approach for researchers and clinicians extending their visions beyond the mouth and understanding the entire context of the patient. Negative impacts of oral conditions on OHRQoL in childhood can reflect on health development, especially in a life stage marked by social and cognitive maturation. Instruments have been developed and cross-culturally adapted to evaluate the impact of oral conditions on the OHRQoL of preschool children and their families. Some features distinguish these instruments and influence their selection, such as: self- or proxy-report; generic- or specific-condition; long- or short-form, and less or more established used in literature. Moreover, theoretical framework, construct validation and availability should also be considered. Nine OHRQoL instruments for preschool children were included in the present literature review. They were created between 2003 and 2017 by developed countries in most cases. The shorter instrument has five items, and the larger has 31 items. Most of them are proxy-reported, generic-condition, and have been relatively well established in the literature. The diversity of instruments indicates the evolution of OHRQoL studies, but there are methodological issues still in need to be improved in future developments or cross-cultural adaptations, according to current psychometric evidence.

Oral health-related quality of life of young people with mucopolysaccharidosis: a paired cross-sectional study

The purpose of the present study was to compare the perceptions of the parents/ caregivers of young people with and without Mucopolysaccharidosis (MPS) with regards to their oral health-related quality of life (OHRQoL). A cross-sectional study was conducted with 29 individuals with MPS and 29 normotypic individuals aged three to 21 years and their parents/caregivers. All parents/caregivers of young people with MPS in follow-up at two reference hospitals in the city of Belo Horizonte, southeastern Brazil, were invited to participate in the study. Individuals without MPS were recruited from the pediatric clinics of both hospitals. Parents/caregivers answered a structured questionnaire addressing the sociodemographic characteristics, behavioral habits and medical and dental history of the children as well as the Brazilian short-form version of the Parental-Caregiver (P-CPQ). The individuals with and without MPS were examined for malocclusion, dental caries and oral hygiene by an examiner who had undergone training and calibration exercises. Mean age of the subjects was 12.1 years (± 4.2). Comparing total P-CPQ scores and scores on the oral symptoms, functional limitations and wellbeing domains, the parents/caregivers individuos with MPS reported a statistically significant greater negative impact on OS domain than their counterparts. Regarding the clinical variables, malocclusion was also associated a greater negative impact on OHRQoL of young people with MPS when compared to those of young people without MPS. Our findings show the great negative impact caused by the malocclusion of young people with MPS.

Parental-Caregivers Perceptions Questionnaire (P-CPQ): translation and evaluation of psychometric properties of the French version of the questionnaire

BACKGROUND

The Parental-Caregivers Perceptions Questionnaire (P-CPQ) is a measure of parental/caregivers' perceptions of the impact of children's oral health on quality of life. The aim of the study was evaluate the psychometric properties of the French version of the P-CPQ.

METHOD

The original P-CPQ was developed in English language and has 31 items divided into four sub-scales. This cross-sectional study used the translation-back translation method. The translated questionnaire was pretested on 14 parents-caregivers to obtain the final French version. The psychometric properties were tested on 142 parents/caregivers of three clinical groups of children from 8 to 10 years old without dental/facial anomalies (presumed healthy), with oral-facial clefts and with oral-dental anomalies linked to a rare disease other than cleft, approached in the waiting room of the Centre of the Hospital Rothschild in Paris, France, where the children attended treatment. Internal consistency was assessed by Cronbach's alpha and test-retest reliability by Intra-class Correlation Coefficient (ICC). Construct validity was measured by correlations between the total scores and the global ratings of oral health and overall wellbeing, and tested using exploratory factor analysis (EFA) and the factorial structure was evaluated by the partial confirmatory factor analysis (PCFA). Discriminant validity was determined using Kruskall-Wallis test.

RESULTS

The mean (standard deviation) P-CPQ score was 18.73(18.79). Internal consistency was confirmed by a Cronbach alpha of 0.85. The test-retest reliability revealed that the responses to items were satisfactorily stable (ICC = 0.88). Construct validity was demonstrated by significant correlation coefficients between the total scale and the global ratings (r = 0.54 and 0.46; p < 0.001). Factor analysis with Principal Component Analysis extracted seven factors explaining 65.23% cumulative variance. Goodness-of-fit indices for partial confirmatory factor analysis were satisfactory for the 7-factors model of the French-PCPQ version. There were statistically significant differences between clinical groups regarding the total scale, thus demonstrating discriminant validity (p < 0.001).

CONCLUSION

This French P-CPQ version showed reliability and validity comparable to the previous versions. However, the cross-cultural structure of the subscales should be further evaluated.

Development and Validation of a Novel Generic Health-related Quality of Life Instrument With 20 Items (HINT-20)

Objectives

Few attempts have been made to develop a generic health-related quality of life (HRQoL) instrument and to examine its validity and reliability in Korea. We aimed to do this in our present study.

Methods

After a literature review of existing generic HRQoL instruments, a focus group discussion, in-depth interviews, and expert consultations, we selected 30 tentative items for a new HRQoL measure. These items were evaluated by assessing their ceiling effects, difficulty, and redundancy in the first survey. To validate the HRQoL instrument that was developed, known-groups validity and convergent/discriminant validity were evaluated and its test-retest reliability was examined in the second survey.

Results

Of the 30 items originally assessed for the HRQoL instrument, four were excluded due to high ceiling effects and six were removed due to redundancy. We ultimately developed a HRQoL instrument with a reduced number of 20 items, known as the Health-related Quality of Life Instrument with 20 items (HINT-20), incorporating physical, mental, social, and positive health dimensions. The results of the HINT-20 for known-groups validity were poorer in women, the elderly, and those with a low income. For convergent/discriminant validity, the correlation coefficients of items (except vitality) in the physical health dimension with the physical component summary of the Short Form 36 version 2 (SF-36v2) were generally higher than the correlations of those items with the mental component summary of the SF-36v2, and vice versa. Regarding test-retest reliability, the intraclass correlation coefficient of the total HINT-20 score was 0.813 (p<0.001).

Conclusions

A novel generic HRQoL instrument, the HINT-20, was developed for the Korean general population and showed acceptable validity and reliability.

Impact of molar-incisor hypomineralization on oral health-related quality of life in schoolchildren

This study evaluated the impact of molar-incisor hypomineralization (MIH) on oral health-related quality of life (OHRQoL) according to the perceptions of schoolchildren and their parents/caregivers. This cross-sectional study consisted of a sample of 594 schoolchildren between 11 and 14 years of age and their parents/caregivers who answered the questionnaires CPQ11-14ISF:16 and P-CPQ, respectively. The main independent variable of this study was MIH of the schoolchildren. Experience of dental caries, malocclusion, and socioeconomic status were treated as confounding variables. Statistical analysis used descriptive analysis and Poisson regression with robust variance. The prevalence of MIH was 18.9%. The overall P-CPQ score ranged from 0 to 35 (average = 7.26 ± 6.84), and the overall CPQ11-14ISF:16 score ranged from 0 to 47 (average = 11.92 ± 7.98). Severe MIH was associated with a greater negative impact of the "functional limitation" domain (RR = 1.41; 95%CI = 1.01-1.97), according to parents'/caregivers' perceptions. Severe MIH was associated with a greater negative impact of the "oral symptom" domain (RR = 1.30; 95%CI = 1.06-1.60) and functional limitation domain (RR = 1.42; 95%CI = 1.08-1.86), according to the schoolchildren's perceptions. Schoolchildren with severe MIH had a greater negative impact on the oral symptom and functional limitation domains than those without MIH. According to parents'/caregivers' perceptions, schoolchildren with severe MIH had a greater negative impact on the functional limitation domain than those without MIH.

Validity and reliability of short forms of parental-caregiver perception and family impact scale in a Telugu speaking population of India

Background

Parental-Caregiver Perception Questionnaire (P-CPQ) and Family Impact Scale (FIS) are commonly used measures to evaluate the parent’s perception of the impact of children’s oral health on quality of life and family respectively. Recently, shorter forms of P-CPQ and FIS have been developed. No study has sought to validate these short forms in other languages and cultures. This study aimed to evaluate the validity and reliability of FIS, 8 and 16-item P-CPQ in a Telugu speaking population of India.

Methods

For this cross-sectional study, a multi-stage random sampling technique was used to recruit 11–13 year-old schoolchildren of Medak district, Telangana, India and their parents (n = 1342). Parents were approached with questionnaires through their children who underwent clinical examinations for dental caries, fluorosis and malocclusion. The translated versions underwent pilot testing (n = 40), test-retest reliability was also assessed (n = 161).

Results

The overall summary scale and subscales of the short forms of P-CPQ and FIS failed to discriminate between the categories of dental caries severity. Also, malocclusion status was not related to the domain or overall scores of both the short forms of P-CPQ. There were significant differences in subscale and overall scores of 16 and 8-item P-CPQ and FIS between the fluorosis categories_. Both 16 and 8-item P-CPQ summary scales were significantly related to parent’s global rating of oral health (16-item, r = 0.30, p < 0.01; 8-item, r = 0.28, p < 0.01) and overall wellbeing (16-item, r = 0.22, p < 0.01; 8-item, r = 0.22, p < 0.01), thereby exhibiting good construct validity. However, the correlation of emotional and social wellbeing scales of short forms of P-CPQ and FIS with global ratings was of low strength. Cronbach’s alphas for FIS, 16-items and 8-items P-CPQ scales were 0.78, 0.83 and 0.71 respectively, while the Intra-Class Correlation coefficients were 0.752, 0.812 and 0.816 respectively. Cronbach’s alphas for most of the subscales of short forms of P-CPQ were less than 0.7.

Conclusions

The overall scales of 16 and 8-items P-CPQ scales demonstrated good construct validity while the construct validity of FIS was questionable. Discriminant validity of all the three instruments was good only in relation to fluorosis. Overall scales of all three short forms exhibited acceptable internal consistency and reliability on repeated administrations.

Oral health and quality of life of children and adolescents with juvenile idiopathic arthritis according to their caregivers' perceptions

The aim of this study was to assess the correlation between oral health indicators and oral health-related quality of life (OHRQoL) of children and adolescents with juvenile idiopathic arthritis (JIA) according to their caregivers' perceptions. Parents or guardians (mean age, 40.6 years; standard deviation [SD] = 10.97 years) of children and adolescents with JIA (n = 17; mean age, 9.8 years; SD = 2.86) and parents or guardians of healthy children and adolescents (n = 15; mean age, 10.7 years; SD = 2.16) filled the short form of the Brazilian Parental-Caregiver Questionnaire (SF: 13 - B-PCPQ). Dental evaluations were performed on all children. There was no significant difference in SF: 13 - B-PCPQ scores of the two groups. Children and adolescents with JIA had fewer caries in their primary dentition and more gingival bleeding after probing than those without JIA. The frequency of temporomandibular disorders was 50.0% for JIA patients and 46.7% for their healthy counterparts. There was no correlation between oral health indicators and SF: 13 - B-PCPQ scores. As perceived by caregivers, JIA did not negatively impact the well-being of their children and adolescents as related to oral health, and their OHRQoL did not correlate with oral health status.

Development and validation of a social capital questionnaire for adolescent students (SCQ-AS)

Objectives

Social capital has been studied due to its contextual influence on health. However, no specific assessment tool has been developed and validated for the measurement of social capital among 12-year-old adolescent students. The aim of the present study was to develop and validate a quick, simple assessment tool to measure social capital among adolescent students.

Methods

A questionnaire was developed based on a review of relevant literature. For such, searches were made of the Scientific Electronic Library Online, Latin American and Caribbean Health Sciences, The Cochrane Library, ISI Web of Knowledge, International Database for Medical Literature and PubMed Central bibliographical databases from September 2011 to January 2014 for papers addressing assessment tools for the evaluation of social capital. Focus groups were also formed by adolescent students as well as health, educational and social professionals. The final assessment tool was administered to a convenience sample from two public schools (79 students) and one private school (22 students), comprising a final sample of 101 students. Reliability and internal consistency were evaluated using the Kappa coefficient and Cronbach's alpha coefficient, respectively. Content validity was determined by expert consensus as well as exploratory and confirmatory factor analysis.

Results

The final version of the questionnaire was made up of 12 items. The total scale demonstrated very good internal consistency (Cronbach's alpha: 0.71). Reproducibility was also very good, as the Kappa coefficient was higher than 0.72 for the majority of items (range: 0.63 to 0.97). Factor analysis grouped the 12 items into four subscales: School Social Cohesion, School Friendships, Neighborhood Social Cohesion and Trust (school and neighborhood).

Conclusions

The present findings indicate the validity and reliability of the Social Capital Questionnaire for Adolescent Students.